You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
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DDD-1883A | What is PASRR? | 02/01/2023 |
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DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
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LCR-1084A-S | Solicitud de Renovación o Certificado de HCBS Modificado para Proveedores Independientes | 02/01/2023 |
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LCR-1084A | Application for Renewal or Amended HCBS Certificate for Independent Providers | 02/01/2023 |
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DDD-1658A | Agency With Choice: Individual Representative (English) | 02/01/2023 |
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DDD-1658A-S | Agency With Choice: Individual Representative (Spanish) | 02/01/2023 |
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FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
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DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
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30th Month December 2022 | 30th Month Financial Report FY 2023 through December 2022 | 01/31/2023 |
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2022 Homeless Lottery Funds Report | 2022 Homeless Lottery Funds Report | 01/30/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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RSA-1376A | Request for Vending Services Placement | 08/01/2019 |
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DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
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DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
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RSA-1312A | Authorization for Disclosure of Health Information to RSA | 07/01/2019 |
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RSA-1312A-S | Autorización Para Divulgación De Información De Salud a RSA | 07/01/2019 |
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CCA-0206A-S | Cuestionario para la Entrevista de Certificación Inicial | 07/01/2019 |
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CCA-1260A-S | Solicitud de Proveedor Suplente | 07/01/2019 |
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CCA-1261A-S | Solicitud de Proveedor Certificado de Cuidado de Niños Familiar | 07/01/2019 |
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CCA-1259A | DES Certified Home-Based Child-Care Provider Pre Application | 07/01/2019 |
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UB-099-Y | Certification of Understanding (English / Spanish) | 07/01/2019 |
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